Abstract: Systems, circuit arrangements, and circuit operation that determine the state of charge of a battery used to provide power to an electrically powered device. The example circuit arrangement of this disclosure may include a selectable sense resistor circuit, a voltage-controlled oscillator (VCO) with a programmable gain preamplifier, an integrator, and a comparator configured to sample the sense resistor measurement and determine an amount of charge from the battery per unit time. The circuit operation may also include slow chop technique to cancel residual input referred offset, where “slow” refers to a chop period that is much longer than the clock period and sample period. By counting the total charge amount used by the electrically powered device and knowing the initial battery charge level at the beginning of life for the battery, the system of this disclosure may determine the state of charge of the battery.

Abstract: Devices, systems and techniques to measure changes in pulse transit time (PTT) and, in some cases, determine pulse wave velocity (PWV), in a blood vessel to support continuous ambulatory monitoring of PTT and/or PWV. Each heartbeat creates a pressure wave that propagates along the arterial system. A pressure wave may travel faster along a rigid artery when compared to a more flexible artery. In this manner, PTT may be an indirect indicator of blood vessel flexibility and patient health.

Abstract: An example device includes a memory configured to store representations of sensed signals. The example device includes processing circuitry coupled to the memory, the processing circuitry being configured to read or write the representations of the sensed signals in the memory. The example device includes sensing circuitry coupled to the processing circuitry, the sensing circuitry being configured to sense signals indicative of a physiological condition of a patient via a plurality of electrodes and to output to the processor circuitry the representations of the sensed signals. The sensing circuitry includes a switched capacitor charge pump configured to amplify the sensed signals to generate amplified signals.

Abstract: This disclosure includes example medical device systems, and techniques for communicating between medical devices. An example medical device includes memory configured to store parameters for therapy delivery for a patient, communication circuitry, electrical signal generation circuitry, and processing circuitry. The processing circuitry is configured to control the electrical signal generation circuitry to deliver a first electrical signal to an anatomy of the patient. The processing circuitry is configured to, based on the electrical signal generation circuitry delivering the first electrical signal, control the communication circuitry to communicate with another medical device.

Abstract: A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

Abstract: A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

Abstract: In situations in which an implantable medical device (e.g., a subcutaneous ICD) is co-implanted with a leadless pacing device (LPD), it may be important that the subcutaneous ICD knows when the LPD is delivering pacing, such as anti-tachycardia pacing (ATP). Techniques are described herein for detecting, with the ICD and based on the sensed electrical signal, pacing pulses and adjusting operation to account for the detected pulses, e.g., blanking the sensed electrical signal or modifying a tachyarrhythmia detection algorithm. In one example, the ICD includes a first pace pulse detector configured to obtain a sensed electrical signal and analyze the sensed electrical signal to detect a first type of pulses having a first set of characteristics and a second pace pulse detector configured to obtain the sensed electrical signal and analyze the sensed electrical signal to detect a second type of pulses having a second set of characteristics.

Abstract: In situations in which an implantable medical device (e.g., a subcutaneous ICD) is co-implanted with a leadless pacing device (LPD), it may be important that the subcutaneous ICD knows when the LPD is delivering pacing, such as anti-tachycardia pacing (ATP). Techniques are described herein for detecting, with the ICD and based on the sensed electrical signal, pacing pulses and adjusting operation to account for the detected pulses, e.g., blanking the sensed electrical signal or modifying a tachyarrhythmia detection algorithm. In one example, the ICD includes a first pace pulse detector configured to obtain a sensed electrical signal and analyze the sensed electrical signal to detect a first type of pulses having a first set of characteristics and a second pace pulse detector configured to obtain the sensed electrical signal and analyze the sensed electrical signal to detect a second type of pulses having a second set of characteristics.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor a biosensor and other sensors. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from one of the sensors. In response to the first preliminary determination being that the IMD has changed status, the processing circuitry may make a second preliminary determination that the IMD based on a second signal from the biosensor or some other sensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD has changed status.

Abstract: A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

Abstract: A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

Abstract: An example device includes a memory configured to store representations of sensed signals. The example device includes processing circuitry coupled to the memory, the processing circuitry being configured to read or write the representations of the sensed signals in the memory. The example device includes sensing circuitry coupled to the processing circuitry, the sensing circuitry being configured to sense signals indicative of a physiological condition of a patient via a plurality of electrodes and to output to the processor circuitry the representations of the sensed signals. The sensing circuitry includes a switched capacitor charge pump configured to amplify the sensed signals to generate amplified signals.

Abstract: A system, such as an IMD system, includes a tissue conductance communication (TCC) transmitter configured to generate a beacon signal by generating a carrier signal and modulating a first property of the carrier signal according to a first type of modulation. The TCC transmitter is configured to generate a data signal subsequent to the beacon signal by generating the carrier signal and modulating a second property of the carrier signal different than the first property according to a second type of modulation different than the first type of modulation.

Abstract: A device is configured to transmit tissue conductance communication (TCC) signals by generating multiple TCC signals by a TCC transmitter of the IMD. The generated TCC signals are coupled to a transmitting electrode vector via a coupling capacitor to transmit the plurality of TCC signals to a receiving medical device via a conductive tissue pathway. A voltage holding circuit holds the coupling capacitor at a DC voltage for a time interval between two consecutively transmitted TCC signals.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

Abstract: A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

Abstract: A device includes a tissue conduction communication (TCC) transmitter that generates a TCC signal including a carrier signal having a peak-to-peak amplitude and a carrier frequency cycle length including a first polarity pulse for a first half of the carrier frequency cycle length and a second polarity pulse opposite the first polarity pulse for a second half of the carrier frequency cycle length. Each of the first polarity pulse and the second polarity pulse inject a half cycle charge into a TCC pathway. The TCC transmitter starts transmitting the TCC signal with a starting pulse having a net charge that is half of the half cycle charge and transmits alternating polarity pulses of the carrier signal consecutively following the starting pulse.